E-ISSN:2456-3110

Review Article

Management in Bleeding Piles

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 5 May
Publisherwww.maharshicharaka.in

A review of Nagkeshar Churna management in Bleeding Piles

Priya P1*, Sundari Verma D2
DOI:10.21760/jaims.9.5.19

1* Priyanka Priya, Third Year Post Graduate Scholar, Department of Shalya Tantra, Govt Ayurvedic College and Hospital, Patna, Bihar, India.

2 Deepali Sundari Verma, Guide HOD, Department of Shalya Tantra, Govt Ayurvedic College and Hospital, Patna, Bihar, India.

Because of changing in lifestyle of modern society, haemorrhoid leading one of biggest challenging disease nowadays, it has high prevalence and low morbidity. It affect the high-quality of life when it comes to internal haemorrhoid with extreme bleeding the affected person turn out to be integral day by way of day with addition of other symptom associated to blood loss, so at once administration of this nation of affairs, but all of these are expensive, time ingesting ,painful ,have most postoperative complication, and the recurrence cost is moreover high, so we can consider the treatment principle given by Acharya Susuruta, for the management of Arsha, Bhesaj Karma is one among them. Bheshaja Chikitsa is a first line of treatment in various diseases. It is viewed to be a conservative line of remedy useful to cure and stop the recurrence of ailments. According to Indian Herbal System (Ayurveda), Nagkeshar is considered one of the most important herb used widely in bleeding disorders. The Nagkeshar improves digestion and appetite, used in fever, vomiting, nausea, excessive thirst, bad breath, pile, excessive sweating, Skin diseases like herpes, infertility etc.

Keywords: Raktajarsha, Bleeding piles, Bhesaja Chikitsa, Nagkeshar Churna

Corresponding Author How to Cite this Article To Browse
Priyanka Priya, Third Year Post Graduate Scholar, Department of Shalya Tantra, Govt Ayurvedic College and Hospital, Patna, Bihar, India.
Email: 		Priya P, Sundari Verma D, A review of Nagkeshar Churna management in Bleeding Piles. J Ayu Int Med Sci. 2024;9(5):117-120.
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https://jaims.in/jaims/article/view/3205

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-03-09 2024-03-19 2024-03-29 2024-04-08 2024-04-18
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None Nil Yes 23

© 2024by Priya P, Sundari Verma Dand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Priyanka Priya et al. A review of Nagkeshar Churna management in Bleeding Piles

Introduction

Since the beginning of time, Ayurveda has been the science of life and Ayurveda has demonstrated the perfect way to live, which guarantees a disease-free, healthy, and long life. An important branch of the Shalya Tantra is rich in many aspects of contemporary surgical thinking. In his treatise, Acharya Sushruta, the inventor of surgery, in-depth explained the Arsharoga, which was regarded as one of the Ashtamahagada (Eight grave diseases) and was perpetually curable.

Arsha is described as a fleshy growth that obstruct that anal channel and eliminates the existance like enemy.[1]

वातव्याधिः प्रमेहश्च कुष्ठमर्शो भगन्दरम् |

अश्मरी मूढगर्भश्च तथैवोदरमष्टमम् ||४||

अष्टावेते प्रकृत्यैव दुश्चिकित्स्या महागदाः |५| Su.Su.33/4[2]

Haemorrhoids often described as "varicose veins of the anus and rectum", haemorrhoids are enlarged, bulging blood vessels in and about the anus and lower rectum. Arsha a terrible illness that can strike anyone, at anytime, anyplace. In modern day to day life, everybody is busy and neglecting proper diet and lifestyle habits. It results in reducing Agni (digestive fire) or making it Manda, here Mandagni means patient is not able to digest the food material he/she is having at proper speed and time. It results in accumulation or stagnation of Aama which disturbs Doshas at anorectal region, this results in Arsha or Haemorrhoids is excessive and unnatural growth of the Maamsa Dhaatu. These are caused in Guda (anal canal) in folds or sphincters. Guda is Sadhyopranahara Marma, and it is well known for its chronicity and difficult in management.

अरिवत् प्राणिनो मांसकीलका विशसन्ति यत्|

अर्शासि तस्मादुच्यन्ते गुदमार्गनिरोधतः||(अ.हृ.नि. 7 / 1)[3]

The disease in which the Mamsa Ankuras (fleshy masses) which occur at the opening of Guda Marga, obstructs the pathway and trouble the person like an enemy is known as Arsha.

Causes

The exact causes of symptomatic hemorrhoids are unknown.

A number of factors are believed to play important role including

1. Irregular bowel habits (constipation or diarrohea)

2. Lack of exercise

3. Nutritional factor (a low-fibre diet)

4. Increased intra-abdominal pressure (prolonged straining, an intra-abdominal mass, or pregnancy).

5. genetics, absence of valves within the hemorrhoidal veins.

6. Aging.

7. Prolonged sitting

8. Other factors that are believed to increase the risk include

Bheshaja means, ‘Tadeva Yukta Bheshajam Yad Arogyaya Kalpate’, that which restore the health is known as Bheshaja. Bheshaja is a medicament which is known by physician. Being beneficial to cure the disease by physician is known as Bheshajya.[4] The measures adopted to bring about equilibrium of Doshas known as Chikitsa.

The disease Arsha is classified into six types by Sushruta based on the predominance of Doshas[5]

Classification of Arsha

Basis of originBasis of bleedingBasis of DoshasBasis of prognosisBasis of position
SahajaArdra/ ShraviVatajaSadhyaExternal
KalajaShushkaPittajaYapyaInternal
KafajaAsadhya
Raktaja
Sannipataj
Sahaj

Samprapti of Arsha[6]

Due to Mithya Ahar Vihar

↓

Tridosh Prakopa and Jatragni Manda

↓

Prakupita Dosha with Rakta moves through Pradhan Dhamni

↓

Dosha aggravation in Guda Pradesha

↓

Guda and Gudavalis are affected

↓


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Produce Mamsankura in Gudavali

↓

Rise to Arsha

Sadyasadhyata[7]

SadhyaSingle Dosha, Bahya Vali, One year.
YapyaTridosha with minimal features
AsadhyaTridosha and Sahaja, Abhyantara Wali,Chirakaleena Upadravayukta

Nidana[8]

Aharaja - Mandagni Guru, Madhura, Sheeta, Abhishyandi, Vidahi, Viruddhara Sevana.Varaha, Mahisha, Aja, Avi Mamsa Bhakshana, Krusha, Shushka, Puti Mamsa Sevana, Lashuna Kilata, Virudha Dhanya Sevana, Paryushita, Puti, Sankeerna Anna Sevana, Atimadhyapana

Viharaja - Basti Karma Vyapat, Ativyayama, Vyavaya, Diwaswapna, Atishayana, Aasan, Utkatasana, Vishamasana, Kathinasana, Ushtra Yana, Adhika Pravahana, Vegadharana

Anya - Amagarbha Bhramsha, Garbhotpeedana, Vishama Prasooti

Nidanarthakara Roga - Atisara, Grahani , Pandu, Gulma

Materials and Methods

Nagkeshar (Mesua ferrea Linn) also called Ironwood and Cobra's saffron.[9] It is ingredient of Misrakgana Chaturjat. Chaturjata is content of many formulations as Prakshepa Dravya. Nagkeshar is illustrating value as Pachan. According to Ayurveda, Nagkesar is good for improving digestion due to its Laghu (easy to digest) property. Taking Nagkesar powder helps to manage bleeding piles, dysentery and stomach irritation due to its astringent property. It's topical application also helps reduce pain and inflammation due to its analgesic and anti-inflammatory properties. In Charak Samhita, Nagkeshar's single use in Arsha Chikitsa is described.

Properties of Nagkeshar

It has beneficial properties like

  • Haemostatic properties anti-inflammatory properties
  • Liver appetizer.
  • Diuretic (expelling excess water from the body)
  • Analgesic (pain-relieving)
  • Antipyretic (reducing fever)
  • Antibacterial
  • Anti-fungal activity
  • Anti arthritic properties
  • Anti oxidant
  • Antibacterial properties
  • Anti-fungal activity
  • Anti-arthritic properties
  • Anti-oxidant activity.

Potential use of Nagkeshar in piles

Hemorrhoids also called as piles, are clumps of dilated veins in the anus and lower rectum.10This makes defecating difficult with continuous throbbing pain accompanied by bleeding stools. Bleeding disorders occur due to an imbalance in Pitta (heat) Dosha. Nagkesar may have some effect in the management of bleeding piles as may help in pacifying Pitta Dosha, resulting in a balance in the body’s heat. It helps in reducing the colonic motility and thereby, helps in irritable bowel syndrome. Powder of Nagkesar aids digestion and also increased the vital capacity of lungs getting increased for the proper utilization of Prana. Hence, it was assumed that the Nagkesar plant shows anti-spasmodic effect by inhibition the action potential generation in the acetyl choline and muscarinic receptor which is further responsible for the inhibition of myosin which results in the smooth muscles relaxation and therefore also relax colonic motility and cramps.

Discussion

As mentioned above, results from various Samhita and Nighantus studies indicates Nagkeshar has Kashaya Ras, Katu Vipaka, Ushna Veerya, Laghu, Ruksha, Guna & Kaphapittahara. It possesses many qualities, as Pachan, Raktastambhana, Swedaghna, Kandughna, Dourgandhanashan, Jwarghna, Trushna, Kushtha. It acts as antibacterial, anti-oxidant, immunomodulatory, and progestional activity. It also exerting influence on the Digestive system, Skin disorders, etc. According to Samhitas and Nigantus, Nagkeshar used in various form or medium. The review indicates that Nagkeshar


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Priyanka Priya et al. A review of Nagkeshar Churna management in Bleeding Piles

may be useful in many ailments. due to this properties Nagkeshar have good effect on Arsha.

Conclusion

Samhita, Nighantu, Astanga Hrudayam are the basic literature to understand and for identification of variety of different medicinal plants. On review of Nagkeshar in different Samhita and Nighantus we find many synonyms and properties along with useful formulations of medicines and their medicinal uses.

References

1. Shastri AD. Sushruta Samhita, Vol-I. Ayurveda Tatwa Sandeepika Hindi Commentary. Nidanasthana Adhayaya 2/17.Varanasi; Chaukhamba Sanskrit Sansthana; 2010.

2. Sushruta Samhita 33/4 editor Kaviraj Ambikadutta Shashtri, Chaukhambha Sanskrit Sansthan edition reprint 2018

3. Astang hrdayam of vagbhata Nidana 7/1 edited vidyotini hindi commentary chaukhambha prakashan edition reprint 2019.

4. Bhisagacharya Satyapala, editor Kashyap Samhita Vriddhajeevakiya tantra with The Vidyotani Hindi Commentary and Hindi Translation of Sanskrit Introduction, Khilasthana chapter-3, verse 28, Edition 1st (reprint), Chaukhambha Visvabharti Oriental publishers and distributors, Varanasi, 2001.

5. Susuruta Samhita Nibandh Sangraha Dhalhana edited by vaidyajadavji trikamji Acharya chaukambha Sanskrit sansthan edition- 2012 nidansthana chapter no. 2 verse no.3 page no.270 pp824.

6. Das A Concise text book of surgery Kolkata; Published by S. Das. 13, Old Mayor’s Court, 2014;1076-1077.

7. Agnivesha, Charaka samhita, Ayurveda Deepika commentary of Chakrapani, edited by; Vaidya Yadavji Trikamji Acharya, Chaukhamba Orientalia, Varanasi, reprint; chikitsa sthana, 2015; 14: 27-31.

8. Agnivesha, Charaka Samhita, Ayurveda Deepika commentary of Chakrapani, edited by; Vaidya Yadavji Trikamji Acharya, Chaukhamba Orientalia, Varanasi, reprint chikitsa sthana, 2015; 14: 21-22.

9. Thakur, Shifali & Kaurav, Hemlata & Chaudhary, Gitika. (2021). Mesua ferrea Linn. (Nagkesar): A Potent Antimicrobial Plant Species. International Journal of Current Pharmaceutical Research. 6-13. 10.22159/ijcpr.2021v13i4.42734.

10. M Sriram Bhat SRB’s Manual of Surgery New Delhi; Jaypee Brothers Medical Publishers (P) Ltd, 2013; 1042. 10


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